Retinal Vein Occlusion - Market Insights, Epidemiology, and Market Forecast - 2030

DelveInsight’s ‘Retinal Vein Occlusion—Market Insights, Epidemiology, and Market Forecast–2030’ report delivers an in-depth understanding of the RVO, historical and forecasted epidemiology as well as the RVO market trends in the United States, EU5(Germany, France, Italy, Spain, and the United Kingdom) and Japan.

The RVO market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM RVO market size from 2017 to 2030. The report also covers current RVO treatment practice/algorithm, market drivers, market barriers, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.

Geography Covered
• The United States
• EU5 (Germany, France, Italy, Spain, and the United Kingdom)
• Japan

Study Period: 2017–2030
Retinal Vein Occlusion Disease Understanding and Treatment Algorithm
Retinal Vein Occlusion Overview
Retinal vein occlusion, one of the most frequently occurring retinal vascular disorders in elderly patients, develops predominantly in individuals over age 65 years. The main risk factors for RVO include age and systemic vascular disorders. It is categorized into central RVO (CRVO) and branch RVO (BRVO) according to the site of blockage in the retinal vein. CRVO is divided further into nonischemic and ischemic types according to the perfusion status based on fluorescein angiography. BRVO consists of major branch RVO (when one of the major branch retinal veins is occluded, usually near, or rarely at, the optic disc) and macular branch RVO (when only one of the macular venules is occluded).Macular edema is the major complication of significant visual loss in patients with CRVO and BRVO, and various treatments have been used to improve macular edema and cause regression of intraocular neovascularization.

The initial examination of a patient with an RVO includes all relevant aspects of the comprehensive adult medical eye evaluation, with particular attention to those aspects related to retinal vascular disease. Several tests are being used for the diagnosis of RVO such as Optical coherence tomography (OCT), and fluorescein angiography (FA). Apart from this, Systemic evaluation is often performed in patients with CRVO and is directed by the patient’s age, coexisting risk factors, and medical history. In RVO, intravitreal steroids and anti-VEGF therapy are used in cases of macular perfusion and macular ischemia, with the laser of use in situations of neovascularization. Response to treatment may be measured by improvement of visual acuity (as a measure of photoreceptor status) and retinal thickness (as a measure of leakage).Growth of the RVO market is expected to be mainly driven by an increase in the number of geriatric people, an increase in market penetration of emerging therapies, readily uptake of current as well as emerging therapies with patient convenient RoA, and increasing awareness about this disease.

Retinal Vein Occlusion Diagnosis
The initial examination of a patient with an RVO includes all relevant aspects of the comprehensive adult medical eye evaluation, with particular attention to those aspects related to retinal vascular disease. An initial history should consider such as the location and duration of vision loss, current medications, medical history and ocular history.

The initial examination includes visual acuity, pupillary assessment for a relative afferent pupillary defect that corresponds to the level of ischemia and is also predictive for eyes at risk for neovascularization, slit-lamp biomicroscopy, looking carefully for fine, abnormal, new iris vessels, IOP, gonioscopy, the examination of the peripheral retina and vitreous and binocular funduscopic evaluation of the posterior pole.

If used appropriately, several imaging tests may enhance the clinical examination and optimize patient care. The most common tests include the following: Optical coherence tomography: optical coherence tomography provides high-resolution imaging of the macula. it is extremely useful to detect the presence and extent of any associated macular edema, vitreoretinal interface changes, and subretinal fluid, Fluorescein angiography: is used to evaluate the extent of the vascular occlusion, the degree of ischemia (ischemic as defined by the CVOS eyes with 10 disc areas of capillary nonperfusion on standard FA vs. nonischemic), and the extent of macular edema. Angiography can identify macular capillary nonperfusion that may explain the associated vision loss as well as the response to therapy, Systemic evaluation: is often performed in patients with CRVO and is directed by the patient’s age, coexisting risk factors, and medical his¬tory. Assessment should be performed in conjunction with an internist, as patients with RVO may be at higher risk of cardiovascular disease and cere¬brovascular accidents.

Retinal Vein Occlusion Treatment
A person suffers from RVO when one of the veins in the retina becomes blocked. It may lead to varying degrees of vision loss, depending on the severity and location of the blockage. Currently, some of the treatments for retinal vein occlusion include: Intravitreal Injection of Anti-Vascular Endothelial Growth Factor (VEGF) Drugs, Intravitreal Injection of Corticosteroid Drugs, Focal Laser Therapy, and Pan-Retinal Photocoagulation Therapy.

Intravitreal injections are used to administer medications to treat a variety of retinal conditions. Age-related macular degeneration (AMD), diabetic retinopathy, and RVO are the most common conditions treated with intravitreal anti-VEGF drugs. In addition to this, Intravitreal steroids are also used in diabetic retinopathy, RVO, and uveitis. The anti-VEGF drugs and steroids help reduce fluid leakage associated with these disorders. At present, Anti-VEGF drugs are markedly more effective in the treatment of RVO than any other treatment modality. Among all the available treatment choices, anti-VEGF drugs provide the greatest improvement in VA. The blockage of venous circulation causes an elevation of intraluminal pressure in the capillaries, leading to hemorrhages and leakage of fluid within the retina, increase of interstitial pressure, and a consequent reduction of retinal perfusion. Steroid injections are another option which acts to reduce the inflammation in the retina caused by the RVO. Corticosteroids have anti-inflammatory, antiangiogenic, and anti-permeability properties that make them an attractive therapeutic option for a variety of posterior segment diseases. While steroids may be considered in patients with systemic cardiovascular risk, surgery remains advisable only for very few patients.

Retinal Vein Occlusion Epidemiology
The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total Prevalent Cases of RVO, Diagnosed Prevalent Cases of RVO, Gender-specific Diagnosed Prevalent Cases of RVO, Age-specific Diagnosed Prevalent Cases of RVO, Type-specific Diagnosed Prevalent Cases of RVO, and Treated Cases of RVO in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and United Kingdom) and Japan from 2017 to 2030.

Key Findings
This section provides glimpses of the RVO epidemiology in the 7MM.
• In the year 2017, the total prevalent cases of RVO were 2,225,011 cases in the 7MM, which is expected to increase in the forecast period (2020–2030).
• In 2017, the total diagnosed prevalent cases of RVO in the 7MM were 1,947,496
Country Wise- Retinal Vein Occlusion Epidemiology

The epidemiology segment also provides the RVO epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

Retinal Vein Occlusion Drug Chapters
This segment of the RVO report encloses the detailed analysis of the mid- and late-stage (Phase-III and Phase-II) pipeline drugs. It also helps to understand the clinical trial details, expressive pharmacological action, agreements and collaborations, approval, and patent details of each included drug and the latest news and press releases.

Retinal Vein Occlusion Emerging Technique
TLC399 (ProDex): Taiwan Liposome Company
TLC399 is the proprietary BioSeizer formulation of dexamethasone sodium phosphate (DSP), intended as an intravitreal, or in-eye, injection for the treatment of macular edema due to retinal vein occlusion. TLC399 in preclinical models has been shown to provide therapeutic levels of DSP in the eye for at least six months after a single administration and have also demonstrated its potential to decrease the thickness of the retina and improve vision. A phase I/II safety trial has demonstrated encouraging signs of efficacy in both the reduction of retinal central subfield thickness and improvements in visual acuity. A larger randomized, double-blind, dose-finding phase II trial is underway. The company is also evaluating opportunities to develop TLC399 in diabetic macular edema in combination with intravitreal anti-VEGF drugs.

GB-102: Graybug Vision
GB-102 is an intravitreal, microparticle depot formulation of the anti-VEGF sunitinib. Sunitinib is a small molecule receptor tyrosine kinase inhibitor that acts as a potent inhibitor of all VEGF pathways, which are known to cause angiogenesis and vascular leakage in the retina, leading to vision decline. The VEGF pathways play an influential role in the development and progression of wet AMD, and there is mechanistic and clinical evidence indicating that a more complete inhibition of these pathways, as offered by sunitinib, could lead to superior patient outcomes compared to current treatments that target only limited VEGF pathways, specifically VEGF-A. The company believes that extending the duration of treatment while expanding the spectrum of neovascular inhibition of all VEGF pathways is differentiated from the current standard of care and may lead to better patient outcomes (Graybug Vision).
More products and detail in the report…

Retinal Vein Occlusion Market Outlook
Retinal vein occlusion (RVO) is a common vascular disorder of the retina and one of the most common causes of vision loss worldwide. Specifically, it is the second most common cause of blindness from retinal vascular disease after diabetic retinopathy.

There’s no medication available that’s specific for retinal artery occlusions. Most people with this condition will have permanent changes to their vision. The main goal of treatment is to stabilize vision by sealing off leaking blood vessels.

Unfortunately, there is no way actually to unblock retinal veins. However, the doctor can treat any health problems that seem to be related to RVO. Vision may come back in some eyes that have had an RVO. About one-third have some improvement, about one-third stay the same and about one-third gradually improve, but it can take a year or more to learn the outcome. In some cases, the blocked vessels will lead to fluid accumulation in the retina, like sponges absorbing water. In others, they may cause the formation of new blood vessels. The current treatment options of RVO intend to minimize the damage, as there is no proven treatment to improve vision loss in the long term. The therapy aims to prevent further visual loss and its complications, such as macular edema, ischemia, or neovascularization.

Some of the treatments for RVO include Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs. These drugs target VEGF, which is an important growth factor that causes macular edema. Intravitreal injection of corticosteroid drugs is the type of drug to combat the inflammatory components which lead to edema. Intraocular injections of steroids are another potential treatment for eyes that don’t respond to anti-VEGF drugs. While intraocular steroids can have some side effects such as an increase in eye pressure and cataract progression, in most cases, these side effects can be controlled.

Focal laser therapy is another type of treatment that provides lasers to areas of swelling to cause a reduction in edema. Laser treatment may also be used along with anti-VEGF therapy in hard-to-treat cases. Laser therapy for macular edema involves applying light laser pulses to the macula in a grid pattern. Pan-retinal photocoagulation therapy is also a treatment option that is used when patients have new blood vessel formation following the RVO.

Several other treatment strategies focus on the surgical treatment of the occluded retinal vein. Some of the approaches include radial optic neurotomy, chorioretinal venous anastomosis, vitrectomy with or without internal limiting membrane peeling, and others.

Currently, there are only three FDA approved products for RVO treatment, including Lucentis (ranibizumab, Genentech), Eylea (aflibercept, Regeneron), Ozurdex (dexamethasone intravitreal implant, Allergan Pharmaceuticals) while Avastin is used as an off-label therapy that help in maintaining or improving the vision.
According to DelveInsight, the RVO market is expected to change in the study period 2017–2030.

Key Findings
This section includes a glimpse of the RVO 7MM market.
• The current market of RVO in the 7MM was USD 2,127.70 million in the year 2017.
• TLC399 (ProDex), AR-1105, and GB-102, are the phase II therapies that are expected to enter the market in the forecast period (2020–2030). All these therapies are going to compete with the current corticosteroids and will be targeting the BRVO and CRVO patient pool.
• The current market of RVO is dependent on the use of anti-VEGF, corticosteroids, laser therapy, and several other off-labeled therapies. Among the present treatment option, anti-VEGF occupies the maximum market share. The anti-VEGF molecules that are being used in the present market include, ranibizumab, aflibercept, and bevacizumab. Avastin is a less expensive anti-VEGF drug as compared to Eylea, hence is used mostly as off-labeled therapy. At present, around 5–10% of people are taking the steroids, and going for laser therapy

Market Outlook for Seven Major Markets
This section provides the total RVO market size and market size by therapies in the United States, Germany, France, Italy, Spain, the United Kingdom, and Japan.

Retinal Vein Occlusion Drugs Uptake
This section focusses on the rate of uptake of the potential drugs that are expected to get launched in the market during the study period 2017–2030. The analysis covers RVO market uptake by drugs; patient uptake by therapies; and sales of each drug.
This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs, and allow the comparison of the drugs on the basis of market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.

Retinal Vein Occlusion Development Activities
The report provides insights into different therapeutic candidates in phase II, and phase III stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities
The report covers the detailed information of collaborations, acquisition, and merger, licensing, and patent details for RVO emerging therapies.

Competitive Intelligence Analysis
We perform competitive and market intelligence analysis of the RVO market by using various competitive intelligence tools that include–SWOT analysis, PESTLE analysis, Porter’s five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.

Scope of the Report
• The report covers the descriptive overview of RVO, explaining its causes, signs and symptoms, pathogenesis, and currently available therapies.
• Comprehensive insight has been provided into the RVO epidemiology and treatment.
• Additionally, an all-inclusive account of both the current and emerging therapies for RVO is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
• A detailed review of the RVO market; historical and forecasted is included in the report, covering the 7MM drug outreach.
• The report provides an edge while developing business strategies by understanding trends shaping and driving the 7MM RVO market.
Report Highlights
• RVO market is anticipated to increase for the study period 2017–2030.
• Emerging therapies include Brolucizumab, ONS-5010, TLC399 (ProDex), AR-1105, and GB-102 are expected to be launched as emerging therapies for RVO during the forecast period 2020–2030.
• In the coming years, RVO market is set to change due to the rising awareness of the disease, and incremental healthcare spending across the world; which would expand the size of the market to enable the drug manufacturers to penetrate more into the market.
• The companies and academics are working to assess challenges and seek opportunities that could influence RVO R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
• Major players are involved in developing therapies for RVO. Launch of emerging therapies will significantly impact the RVO market.
• Our in-depth analysis of the pipeline assets across different stages of development (phase III and phase II), different emerging trends and comparative analysis of pipeline products with detailed clinical profiles, key competitors, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.

Retinal Vein Occlusion Report Insights
• Patient Population
• Therapeutic Approaches
• RVO Pipeline Analysis
• RVO Market Size and Trends
• Market Opportunities
• Impact of upcoming Therapies
Retinal Vein Occlusion Report Key Strengths
• 11-Years Forecast
• 7MM Coverage
• RVO Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Market
• Drugs Uptake
Retinal Vein Occlusion Report Assessment
• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Market Drivers and Barriers

Key Questions
Market Insights:
• What was the RVO market share (%) distribution in 2017 and how it would look like in 2030?
• What would be the RVO total market size as well as market size by therapies across the 7MM during the forecast period (2020–2030)?
• What are the key findings pertaining to the market across the 7MM and which country will have the largest RVO market size during the forecast period (2020–2030)?
• At what CAGR, the RVO market is expected to grow at the 7MM level during the forecast period (2020–2030)?
• What would be the RVO market outlook across the 7MM during the forecast period (2020–2030)?
• What would be the RVO market growth until 2030, and what will be the resultant market size in the year 2030?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Epidemiology Insights:
• What is the disease risk, burden, and unmet needs of RVO?
• What is the historical RVO patient pool in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan?
• What would be the forecasted patient pool of RVO at the 7MM level?
• What will be the growth opportunities across the 7MM with respect to the patient population pertaining to RVO?
• Out of the countries mentioned above, which country would have the highest number of RVO cases during the forecast period (2020–2030)?
• At what CAGR the population is expected to grow across the 7MM during the forecast period (2020–2030)?

Current Treatment Scenario, Marketed Drugs and Emerging Therapies:
• What are the current options for the treatment of RVO along with the approved therapy?
• What are the current treatment guidelines for the treatment of RVO in the US and Europe?
• What are the RVO marketed drugs and their MOA, regulatory milestones, product development activities, advantages, disadvantages, safety, and efficacy, etc.?
• How many companies are developing therapies for the treatment of RVO?
• How many therapies are developed by each company for the treatment of RVO?
• How many emerging therapies are in the mid-stage and late stage of development for the treatment of RVO?
• What are the key collaborations (Industry–Industry, Industry–Academia), Mergers and acquisitions, licensing activities related to the RVO therapies?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitation of existing therapies?
• What are the clinical studies going on for RVO and their status?
• What are the key designations that have been granted for the emerging therapies for RVO?
• What are the 7MM historical and forecasted market of RVO?
Reasons to buy
• The report will help in developing business strategies by understanding trends shaping and driving the RVO.
• To understand the future market competition in the RVO market and Insightful review of the key market drivers and barriers.
• Organize sales and marketing efforts by identifying the best opportunities for RVO in the US, Europe (Germany, Spain, Italy, France, and the United Kingdom) and Japan.
• Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
• Organize sales and marketing efforts by identifying the best opportunities for RVO market.
• To understand the future market competition in the RVO market.